What is bi-polar?

Hey, so lately I've been wondering what bi-polar really was. I'm aware it's a mental disorder where there are steady rise and falls of emotion, but that's about it. Here are some starter questions I have:

- how is it different from mood swings? Does the person literally have no control? If the person were watching a sad movie but was in the 'manic' stage, would they still feel sadness about what they're watching?

- How is it diagnosed? From what age is it noticeable?

- I imagine there are a variety of degrees of bi-polar, correct?

- If I were to write a character with bi-polarism, what are the pitfalls to avoid?

- What happens when the person is in either the 'manic' or 'depression' stage? How long do those stages typically last?

It differs from mood swings by degree of symptoms. Typically a bipolar person in the manic phase is so 'up' as you call it, they don't sleep. They also have delusions during this period that one with a mood swing wouldn't have.

I was actually once misdiagnosed with bi-polar disorder as a teenager. It turns out I just have clinical depression.

So to answer the questions in no order: there are four types of bipolar disorder: stage 1, 2 and 3, and unspecified. 3 is the 'weakest' and 1 is the 'strongest'. It is periods of mania where the world is a bright, wonderful place and manic depressives tend to be susceptible to extremely weird delusional beliefs about themselves. Someone I was once in contact with who had stage 1 used to think that God was coming to visit, he was just taking his time, and so this person would manically clean their house in preparation. In contrast the lows are crushing.

One thing I need to stress, as heavily as I can stress anything - stress like two planets smashing into each other, is that depression when dealing with the mentally ill is NOT feeling sad. It's more you don't have the ability to feel positive emotions. People with depression will sometimes not even leave their beds, because what is the point? They will not speak because who would be interested in what they have to say? They'll not laugh, because there's nothing to laugh about. So whatever you do, do not ask a person depressed 'What's wrong', because that will just make them hate you.

If you tell them to 'cheer up', believe me, you are only making things worse.

The suicidal temptation is also emblematic of people who have mental health issues like bipolar. I don't know what it's like for mentally healthy people who feel like destroying themselves, but people with depression (I've experienced this personally) can be even perfectly calm and logical in their thoughts and planning. I for one planned out my own death, either throwing myself off a bridge in the city I used to live in, and let the River Wear carry my body out to sea, or take the bleach from the kitchen and drink it in the shower so my flatmates had an easier time cleaning up my mess. All the while I was planning this it seemed like the most perfectly natural thing in the world - I wasn't even particularly upset. The reason I didn't actually get up out of bed to grab the bleach from the kitchen was just because I couldn't be bothered to do it.

Another thing I really must stress about depression is nothing sets off the downward spiral. It can be completely random and unprovoked - in my experience it's just happiness seems to stop, and I quickly become very bored and irritated, and I wouldn't have only a few seconds before.

Contrary to whatever you might have been advised above, please don't just look at some health site on mental illness because it's actually an extremely complicated and expansive subject that one site cannot ever fully provide you with if you want to do the subject justice. It's also, which is also rarely stated, very personal - there is no one expression of mental illness. No one form of bipolar disorder.

My advice is to talk to a number of people with manic depression, and even a few mental health professionals, and hear their stories. A lot of them can really open your eyes to how your own brain can actually work to destroy you - it can be (honestly) quite terrifying.

It differs from mood swings by degree of symptoms. Typically a bipolar person in the manic phase is so 'up' as you call it, they don't sleep. They also have delusions during this period that one with a mood swing wouldn't have.

I was actually once misdiagnosed with bi-polar disorder as a teenager. It turns out I just have clinical depression.

So to answer the questions in no order: there are four types of bipolar disorder: stage 1, 2 and 3, and unspecified. 3 is the 'weakest' and 1 is the 'strongest'. It is periods of mania where the world is a bright, wonderful place and manic depressives tend to be susceptible to extremely weird delusional beliefs about themselves. Someone I was once in contact with who had stage 1 used to think that God was coming to visit, he was just taking his time, and so this person would manically clean their house in preparation. In contrast the lows are crushing.

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I've heard of that. If mania is the high period where everything is possible, you can do anything, etc., then the depressive stage is the stark opposite of it. The manic stage can be just as bad as the depressive stage, where the person might do something he/she thinks they can do (but can't) and wind up in the hospital.

One thing I need to stress, as heavily as I can stress anything - stress like two planets smashing into each other, is that depression when dealing with the mentally ill is NOT feeling sad. It's more you don't have the ability to feel positive emotions. People with depression will sometimes not even leave their beds, because what is the point? They will not speak because who would be interested in what they have to say? They'll not laugh, because there's nothing to laugh about. So whatever you do, do not ask a person depressed 'What's wrong', because that will just make them hate you.

If you tell them to 'cheer up', believe me, you are only making things worse.

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I agree. From what I understand, it's just going to make them feel like they're in the wrong for just not 'cheering up'. Understandably, they aren't going to want to talk to people because how would they know if that person isn't going to tell them to just 'be happy'.

So from what I'm gathering, this isn't even sad-level like 'someone I loved died'. This is the complete lacking of positive emotions, they basically feel dead inside. There's no point, there's no use in doing anything. There's no 'look at the bright side' or 'aww, look at that cute kitty sleeping in the chair, that's a bit of happiness there'. Nada.

The suicidal temptation is also emblematic of people who have mental health issues like bipolar. I don't know what it's like for mentally healthy people who feel like destroying themselves, but people with depression (I've experienced this personally) can be even perfectly calm and logical in their thoughts and planning. I for one planned out my own death, either throwing myself off a bridge in the city I used to live in, and let the River Wear carry my body out to sea, or take the bleach from the kitchen and drink it in the shower so my flatmates had an easier time cleaning up my mess. All the while I was planning this it seemed like the most perfectly natural thing in the world - I wasn't even particularly upset. The reason I didn't actually get up out of bed to grab the bleach from the kitchen was just because I couldn't be bothered to do it.

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D: Jesus, that was hard to read. Glad you didn't do it, though.

As for the mentally healthy people who commit suicide? Well, I'm not sure either but I think it's usually when in a fit of extremely high emotions/they can't find a way out, or if they're faced with a terminal illness/very painful condition and decide that it's not worth dragging their family through needless pain by hastening the inevitable. The latter would be the *only* time I would ever consider doing that to myself.

But Jesus, that sounds scary... The brain can be an evil prick sometimes.

Another thing I really must stress about depression is nothing sets off the downward spiral. It can be completely random and unprovoked - in my experience it's just happiness seems to stop, and I quickly become very bored and irritated, and I wouldn't have only a few seconds before.

Contrary to whatever you might have been advised above, please don't just look at some health site on mental illness because it's actually an extremely complicated and expansive subject that one site cannot ever fully provide you with if you want to do the subject justice. It's also, which is also rarely stated, very personal - there is no one expression of mental illness. No one form of bipolar disorder.

My advice is to talk to a number of people with manic depression, and even a few mental health professionals, and hear their stories. A lot of them can really open your eyes to how your own brain can actually work to destroy you - it can be (honestly) quite terrifying.

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That I agree completely. Though I have a different mental disorder (mild generalized anxiety disorder), it's not the type you see on Hollywood, just like depression and bi-polar aren't the type you see on Hollywood. There's so many different variations of it and it depends on the individual person. There's no one-level-everyone's-got-it mental disorder.

Thanks for the replies, it's very insightful. I'll continue doing further research on this.

I agree. From what I understand, it's just going to make them feel like they're in the wrong for just not 'cheering up'. Understandably, they aren't going to want to talk to people because how would they know if that person isn't going to tell them to just 'be happy'.

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It's also the fact that it can remind someone who is mentally ill that they are different from other people, not being understood - it can be quite isolating because it sounds so simple, to just cheer up, but that is something impossible to a person in the throws of a depressive state.

So from what I'm gathering, this isn't even sad-level like 'someone I loved died'. This is the complete lacking of positive emotions, they basically feel dead inside. There's no point, there's no use in doing anything. There's no 'look at the bright side' or 'aww, look at that cute kitty sleeping in the chair, that's a bit of happiness there'. Nada.

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That's a good way to think of it - it is what it's like. I'm not sure if it has a comparable experience to someone who is basically mentally healthy. It's also very hard to explain exactly, meaning it can be very hard to talk about.

D: Jesus, that was hard to read. Glad you didn't do it, though.

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Me too. I don't mind talking about it now - I know how to control my 'dark passenger' (to borrow a phrase from Dexter) much better now. I can't lie to myself, and I'll not lie to you, it's still there - but I feel better equipped to handle and control my self-destructive tendency.

As for the mentally healthy people who commit suicide? Well, I'm not sure either but I think it's usually when in a fit of extremely high emotions/they can't find a way out, or if they're faced with a terminal illness/very painful condition and decide that it's not worth dragging their family through needless pain by hastening the inevitable. The latter would be the *only* time I would ever consider doing that to myself.

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I'm guessing this is right, I honestly don't know. I don't think I would ever consider destroying myself if I didn't have this 'dark passenger'. I'm otherwise by nature and disposition quite cheerful and well-adjusted.

But Jesus, that sounds scary... The brain can be an evil prick sometimes.

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Believe me, it is horrifying on reflection.

That I agree completely. Though I have a different mental disorder (mild generalized anxiety disorder), it's not the type you see on Hollywood, just like depression and bi-polar aren't the type you see on Hollywood. There's so many different variations of it and it depends on the individual person. There's no one-level-everyone's-got-it mental disorder.

Hey, so lately I've been wondering what bi-polar really was. I'm aware it's a mental disorder where there are steady rise and falls of emotion, but that's about it. Here are some starter questions I have:

- how is it different from mood swings? Does the person literally have no control? If the person were watching a sad movie but was in the 'manic' stage, would they still feel sadness about what they're watching?

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Who ever, or wherever you heard that BpD was like moodswings, it was a gross misinterpretation. Bipolar people swing between two "poles" with mania (or hypo mania) at one end and depression at the other. All of a person's normal emotions can be felt and enjoyed during the midst of either pole. It's really more of a problem of context. If it was your birthday, or you just had a blowjob promotion, could you feel sad if you watched that Futurama episode? (You know the one.)

Of course you can. But that feeling of sadness gets filtered through the context of your anticipation of birthday cake or your recent orgasm corner office.

The specifics of mania or depression are a bit more intense. Mania (and hypo mania) is classified by extremely poor judgement, hypersexuality, delusions, racing thoughts, and moderate euphoria. This manifest in a lot of ways we can go over.

Poor judgement: My first psychiatrist told me about one of her patients who, in a full on manic episode, had sex with her roommate, ran to go streaking in the local park, and called the cops on her boyfriend for no reason. On my hypomania the most I've ever done is get arrested for mouthing off to a policeman. Made incredibly stupid purchases, and got in a couple fights with people much larger, over things that were definitely my fault.

Hypersexuality: This one is fairly obvious. It might mean you have furious sex with your wife in every stairwell in the hotel, and on the roof. Sometimes this means you go on a porn binge and give yourself a "Rusty Venture".

We'll get to delusions in a second, so next up is racing thoughts: This is the worst part of Mania or Hypomania. There's a little bit of overlap with OCD there, where you can't stop thinking about things. Usually this is conversations with people you've never met, and you don't know you're doing it until you turn to gesture at them. It might mean you convert 6:5 as a ratio into a decimal, for 6 hours. You forget the answer every time you figure it out and have to start all over again.

Delusions: are a difficult one to parse. You might remember that you have a winning lottery ticket in your desk drawer. You'll call everyone you know to tell them that you are going to win the lottery, and when they tell you that it's Monday, and they don't announce the winners for a week, you tell them you know that, but you've actually already won! They'll see.

Or maybe it's clear from the way your neighbor has arranged the flowers outside her window that she is madly in love with you. She's leaving her boyfriend soon, and all you have to do is put a broom on your car to show her you care. When she doesn't respond you might have to send her a secret message in the margins of the magazine that "accidentally" got delivered to your door.

And all of this feels really really just wonderful. Scary wonderful. The kind of wonderful that you really shouldn't be enjoying this much and it would be kind of nice if you could stop now, please?

The depression phases are easier to explain. Most of that involves ignoring all of your responsibilities. Skipping work, skipping class, skipping errands, skipping showers, skipping breakfast. It easy to get into a cycle of hating everything you've ever done, and that almost comes close to be emotional. But it's really more important to go back to sleep.

- How is it diagnosed? From what age is it noticeable?

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There are a lot of ways to diagnose. The best is getting at SPECT scan or EEG. Under the right circumstances you can actually verify the way a person's brain works. That is very expensive, and only offered in a few areas. More usually you can take the Minnesota Multiphasic Personality Index, or other tests, that graph out your brain function without being inside it.

Or then you might just have a psychologist who has a good feeling about it. The DSM V has a whole list of diagnostic criteria, and it's the doctor's discretion about their application. In extreme cases diagnosis is easy. In @Lemex case, not so much.

For the most part BpD is pretty much impossible to diagnose until 18 or older. Until then the symptoms are mingled to deeply with normal adolescent development.

- I imagine there are a variety of degrees of bi-polar, correct?

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There's cyclothemia (mildly eccentric), Mixed bi-polar (erratic), Bipolar II (misunderstood), Bipolar I (crazy) and Rapid cycling (batshit).
But it gets better! BpD has a +1 invitation! Its called comorbidity, and it means that having just bipolar disorder is actually pretty rare. You can have ADHD, GAD, Borderline, Schizophrenia, OCD, and a host of other lesser know problems. It's a mix and match fun house surprise!

- If I were to write a character with bi-polarism, what are the pitfalls to avoid?

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Bipolar disorder. It's not an "ism". So that would be pitfall one. Your biggest pitfall would be to try and write a crazy character. I can only speak for myself, but I'm not interested in having my disorder boiled down to a bullet point on a character sheet. The best thing to do is write an erratic and enigmatic character, who might have some trouble getting out of bed some days, and who takes their meds when their alarm goes off.

- What happens when the person is in either the 'manic' or 'depression' stage? How long do those stages typically last?

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I answered that one up above, so I guess this is where I sit back an wait for questions. I'm sure you'll have many more.

could you feel sad if you watched that Futurama episode? (You know the one.)

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I do. Luck of the Fryrish. Jurassic Bark is the second saddest and I'll fight whoever disagrees with me!

But in all seriousness, sounds like several members have this covered.

and @Lemex - I've never been diagnosed with anything, but thoughts like those are very common to me as well.. Like if I come to a particularly high hill with no guardrail I actually have to fight the urge- maybe I should just drive off? Why not?

@Jack Asher already covered Bi-polar pretty well, but like anything else, everyone has their own symptoms. In the DSM V, there is a list of all the the symptoms a bi-polar can have, and after asking someone questions, the psychiatrist may label someone as bi-polar if they say they have 2 (3?) of the symptoms.

I've only been diagnosed as bi-polar since 2008, but when I look back now, I can see symptoms that would have gotten me help sooner. In my early 20's I was extremely sexually active with on average a new girl every 2 weeks. I also became addicted to strip clubs and gambling. I would get moments where it seemed everything around me was moving faster than normal or people were talking too fast for me to understand. At the same time I would be moving very slow. Finally I've had several manic episodes where the longest was about 65 hours straight without any sleep. On the same token I've come out of a manic episode and slept for 40 hours straight.

It sucks to be bi-polar. I have to take 4 different medicines each day, and the medicine can make the inside of my head feel like there is cement hardening in there.

I've had several manic episodes where the longest was about 65 hours straight without any sleep.

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Oh, you got me beat, my longest if 56 hours. @Link the Writer you should know that that 56 hours was spent trying desperately to sleep, or find some kind of activity that would tire me out, including getting lost in the RTD bus system for half a day.

Also, to add to the fun, Beepers commit suicide at over twenty times the average. One in five bipolar patients will commit suicide. I'm fond of telling my shrink, "Well, I'm still with the 80%!"

Hey, @Jack Asher (or anyone else who knows): How prevalent is bipolar disorder? What percentage of the population has it? Is it evenly split between males and females, or is there a significant difference in prevalence between the two? Does age affect it - is it more prevalent in young people than in old?

56 hours with no sleep! D: Good Lord, guys! I would've drank an entire six-pack of Guinness by that time out of sheer, sheer desperation to get sleep. @Lewdog , the meds don't sound very pleasant either. :<

how is it different from mood
swings? Does the person literally
have no control?
no control if they stop taking their medication you can tell. They go from mania to suicide depression

- How is it diagnosed? From what
age is it noticeable?
as stated the medical tests, me I look for suicide scars, not the scratches that self harm people do I am talking needed stitches skin missing cuts.

- I imagine there are a variety of
degrees of bi-polar, correct?
I would say they all suffer the same thing a brain that has no brakes, our normal brain stops us, a bpd will not stop until pass out or restrained.

- If I were to write a character
with bi-polarism, what are the
pitfalls to avoid?
if you have not experienced one just think no brakes.

- What happens when the person
is in either the 'manic' or
'depression' stage? How long do
those stages typically last?
as stated above I found I could see the change and tell the girls to take their meds,

one story I will never forget one gf suspected I was leaving her, she stopped taking her medicine and tried to kill me with a axe, took me and three guys to restrain her. sad to say we did break up she went out latter with one of the three guys who helped me.

Erm...I just like to see them as people who so happens to have bi-polar. :/ She must have had an extreme case of bi-polar. This is not the case with every person with bi-polar. As said by Lemex, it's all personal and varies from person to person. With my GAD, I can function pretty well without meds or therapy, but I will always have this gut feeling in my mind that something terrible is about to go wrong and I have to be hyper vigilant about it. I'm constantly scanning the horizon for anything that could go wrong because anything that could go wrong will go wrong. To quote Professor Moody, "CONSTANT VIGILANCE!!!" Those on the extreme end of GAD do need therapy and meds. See what I'm saying, Lance?

But yeah, having bi-polar must be scary to have. Really, any mental disorder where it's basically you vs. your evil brain must be terrifying/annoying depending on the severity of it. But as with any mental or physical disorder, focus on the person, not the disorder. I wouldn't want people to look at me as Mr. Hearing-Impaired or Mr. Mild-Generalized Anxiety Disorder.

when ever I tell people about my life, every one says I should write a book, I have and the book is based on people with bpd I just do not talk about it in my book, so far everyone who has read my first draft likes it.
I hope you realise bpd people are ok and normal when they take their medication, so why are you writing about them and singling them out as few go through life undiagnosed.
but I glad your now the expert on bpd, it was not just one gf I have had that was diagnosed.

when ever I tell people about my life, every one says I should write a book, I have and the book is based on people with bpd I just do not talk about it in my book, so far everyone who has read my first draft likes it.
I hope you realise bpd people are ok and normal when they take their medication, so why are you writing about them and singling them out as few go through life undiagnosed.
but I glad your now the expert on bpd, it was not just one gf I have had that was diagnosed.

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Hey, I'm not an expert. I just felt like you were assuming all people with bpd were like your girlfriend.

girlfriends, I did say I had a few as I will not publicly say how many had bpd.

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Well, I just hope I didn't offend you.

That's my most prominent worry when interacting with people. Sometimes I find myself treating them with extra care regardless of what they have or are. You could be perfectly healthy mentally and physically, yet I'd still treat you like delicate glass. It's wrong, but my anxiety tells me that this is logical. Even if they say that they're fine, my anxiety says otherwise. I don't want to look like an asshole.

So, sorry if I offended. I'll try not to pester you about it. But who knows? I might just do that anyway. Muahaha...

I just figured it's best to not be ignorant about things I don't understand. Problem is: my anxiety makes me afraid to even ask. 'Cause, y'know, I really don't want to say something stupid.

But thanks for the replies everyone! Hope I didn't annoy you all too much. I will now spread my generalized anxiety elsewhere!

Not had any experience of mania, but in a severe depressive mood you begin to not even feel human. Pretty much every feeling goes out the window, besides an incredibly intense and vague frustration with nothing in particular. Desire to do anything goes as well, I think people take desire for granted in everyday life, you never realize how much you just want to be doing stuff and looking at things and just being alive I guess, and it's weird when those feelings disappear. It's becomes very difficult to concentrate, to start with it's hard to focus on tasks, but eventually you can't even focus on your own thoughts and it's feels like your listening to a million different conversations at once and you can't really think at all. Essentially, you just turn into an angry blob. The worst I've ever felt was like this, and when you can't think, feel, or want anything life becomes really weird, I'm not sure I can explain it, but everything just sort of lost its value, like, I started to understand everything as collections of atoms floating about in space, which sounds mega-pretentious, but it made sense at the time.

@Link the Writer - If you were going to write a story using a character with BPD, it might be interesting to write them as undiagnosed. In other words, if you just pick the characteristics that seem pertinent to your character and give them to your character, but never name the condition? It's an interesting way to approach the problem, and nobody will be able to argue with you because you haven't labeled the condition. However, people 'in the know' are likely to recognise the symptoms, and that can actually strengthen your story. Obviously if the character gets treatment, then it'll need to be identified. But, say, 100 years ago, the treatment wouldn't have been there. They would have really struggled to cope. That could give your story an interesting dimension to explore.

Hey, @Jack Asher (or anyone else who knows): How prevalent is bipolar disorder? What percentage of the population has it? Is it evenly split between males and females, or is there a significant difference in prevalence between the two? Does age affect it - is it more prevalent in young people than in old?

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It's somewhere around 2.5% of the general population, we think. Like with any disorder it's difficult to track what percentage of the population has it. While it's split among men and women, women are more likely to have rapid cycling and psychotic features. Obviously because of the difficulty diagnosing it, it's very rare in children. Older generations are probably equally prevalent, but the problem is that they don't seek treatment. The 1/5 statistic was probably much large in the past, because before medication the solution of a shotgun in the mouth was probably a more attractive option.

And guys? BPD is Borderline Personality Disorder. BpD is Bipolar Disorder, or just bipolar for short.

Not had any experience of mania, but in a severe depressive mood you begin to not even feel human. Pretty much every feeling goes out the window, besides an incredibly intense and vague frustration with nothing in particular. Desire to do anything goes as well, I think people take desire for granted in everyday life, you never realize how much you just want to be doing stuff and looking at things and just being alive I guess, and it's weird when those feelings disappear. It's becomes very difficult to concentrate, to start with it's hard to focus on tasks, but eventually you can't even focus on your own thoughts and it's feels like your listening to a million different conversations at once and you can't really think at all. Essentially, you just turn into an angry blob. The worst I've ever felt was like this, and when you can't think, feel, or want anything life becomes really weird, I'm not sure I can explain it, but everything just sort of lost its value, like, I started to understand everything as collections of atoms floating about in space, which sounds mega-pretentious, but it made sense at the time.

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Sounds like a very rough experience to have. :< Um, sorry if I sound dense (and I likely do), is this similar to the chronic depression Lemex was talking about earlier? There's...nothing positive, you don't feel any desire to do anything?

Also, the manic part, um...is it a correct comparison to say that it'd be like if I drank a whole pot of coffee and was convinced that I could do anything and everything? And I couldn't stop myself? Or is that not the case? With the delusions, does it just sort of pop in there without warning and your brain convinces you that they're real/actual fact? Let's say I was convinced that the Moon was going to fall and hit the Earth, how long would that belief last?

I think I'm getting a better understanding of this disorder, though I have a lot of research ahead of me obviously. Already I've got a lot of misconceptions cleared up.

@Link the Writer - If you were going to write a story using a character with BPD, it might be interesting to write them as undiagnosed. In other words, if you just pick the characteristics that seem pertinent to your character and give them to your character, but never name the condition? It's an interesting way to approach the problem, and nobody will be able to argue with you because you haven't labeled the condition. However, people 'in the know' are likely to recognise the symptoms, and that can actually strengthen your story. Obviously if the character gets treatment, then it'll need to be identified. But, say, 100 years ago, the treatment wouldn't have been there. They would have really struggled to cope. That could give your story an interesting dimension to explore.

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That's an interesting idea, Jannert. I could explore how someone with bipolar would have had to cope in a time when there were no such treatment for the disorder. It would definitely make for a more powerful story for that character. That said, I'll still have to do extensive research on bipolar because even if the disorder itself isn't known to that character or to anyone else in his/her time, I still need to know what I'm talking about and not resort to clichés/stereotypes.

I didn't read every comment so sorry if someone else already covered this.

Mania isn't always positive. A lot of people I know assume that because how it is the other pole of depression. Racing thoughts and being in a place that wants you to sit still quietly? Like a grocery line? It can cause sudden and extreme anger.